BROOKSHIRE GROCERY COMPANY
Medical Equipment Supplier Yellow Pages
Tyler, Texas
Provider NPI: 1790858025
Organization Information:Organization Name: BROOKSHIRE GROCERY COMPANY
Practice Location:
113 N NW LOOP 323 ATTENTION PHARMACY DEPT TYLER, TX 75702 US
Tel: 903-593-5369 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
113 N NW LOOP 323 ATTENTION PHARMACY DEPT TYLER, TX 75702 US
Tel: 903-593-5369 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 333600000X | Suppliers Pharmacy | ||
Y | 3336C0003X | Suppliers Pharmacy | TX | 16797 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
463966 | TX | 05 | |
PK | 2105342 | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin